The primary purpose of shoes
is to protect your feet and prevent injury. But in order to do so, they
mustfit Well. Poorly fitted shoes-shoes that are too narrow, too
short. or too large-can cause discomfort, injury and even permanent deformity.

Understanding
the components of proper fit can help you make sensible shoe purchases for
yourself and your family. This brochure describes the parts of a shoe and
how they can affect fit. It also discusses special considerations related
to children's, men's, women's,. work and athletic shoes, and provides recommendations
on footwear selection.

Although style
is often a key consideration in choosing a pair of shoes, the most important
quality to look for in shoes-from a practical standpoint-is durable construction
that will protect your feet and keep them comfortable. In selecting shoes,
keep this basic principle of good fit in mind: Your shoes should conform
to the shape of your feet-your feet should never be forced to conform to
the shape of a pair of shoes. Soreness. blisters, callouses, and, with time,
permanent disfigurements can be caused by habitually crowding, your feet
into shoes that don't fit well.

A shoe is composed
of different parts. Understanding the basics of shoe construction can help
you choose intelligently from among the thousands of available styles.

The toe box is
the tip of the shoe that provides space for the toes. The toe box may be
rounded or pointed and will determine the amount of space provided for the
toes.

The vamp is the upper middle
part of the shoe where the laces are commonly
placed. Sometimes Velcro is used instead of laces.

The sole consists
of an insole and an outsole. The insole is inside the shoe; the outsole
contacts the ground. The softer the sole, the greater the shoe's ability
to absorb shock.

The heel is the
bottom part of the rear of the shoe that provides elevation. The higher
the heel, the greater the pressure on the front of the foot.

The last is the part of the
shoe that curves in slightly near the arch of the foot to conform to the
average foot shape. This curve enables you to tell the right shoe from the
left. On occasion. an orthopaedic surgeon may prescribe a child's shoe that
has a straight or reverse last.

The material from
which the shoe is made can affect fit and comfort. Softer materials decrease
the amount of pressure the shoe places on the foot. Stiff materials can
cause blisters. A counter may be used to stiffen the material around the
heel and give support to the foot.

Because your feet may varyin size,
ask the salesperson to measure the length and width of each of your
feet.

Your feet expand when bearing weight, so stand
while your feet are being measured.

Because swelling during the course of the day
can enlarge your feet, have your feet measured at the end of the day.

The shoes you buy should be fitted to your longer
and wider foot. Although the toe box should be spacious. too much space
can cause the feet to slide around in the shoes, possibly causing blisters
or abrasions.

Shoes should be fitted carefully to your heel
as well as your toes. Check to make sure your heel does not slip out
of the back of the shoe.

Walk around in the shoes to make sure they fit
well and feel comfortable.

Don't select a shoe by size alone. A size 10
in one brand or style may be smaller or larger than the same size in
another brand or style. Buy the shoe that fits well.

Select a shoe that conforms as closely as possible
to the shape of your foot.

Have your feet measured regularly. Their size
may change as you grow older.

If the shoes feel too tight. don't buy them.
There is no such thing as a "break-in period." With time,
a foot may push or stretch a shoe to fit. But this can cause foot pain
and damage.

If one of your feet is considerably larger than
the other, an insole can be added to the shoe on the smaller foot.

Children don't
need shoes until they begin walking, usually at around 12 to 15 months of
age. Until then, socks or booties are enough to protect a crawling infant's
feet and keep them warm. When your child does begin standing and walking,
however, shoes provide an excellent form of protection from injury. After
your child begins wearing shoes, there is nothing wrong with letting him
or her go barefoot indoors.

A good time to buy your child's
first pair of shoes is when he or she starts standing and walking. Shoe
stores that specialize in children's shoes are likely to offer the widest
range of sizes and styles, and will usually take more time to makesure a pairof shoes fits properly.

Never try to force
your child's feet to fit a pair of shoes.

A soft, pliable
shoe with plenty of room, such as a sneaker, is the ideal shoe for children
of all ages. The toe box should provide enough space for growth, and should
be wide enough to allow the toes to wiggle. (A finger's breadth of extra
length will usually allow for about three to six months' worth of growth,
though this can vary depending on your child's age and rate of growth.)

If your child
frequently removes his or her shoes, those shoes may be uncomfortable. Check
your child's feet periodically for signs of too-tight shoes, such as redness,
callouses or blisters. And have your child's feet measured periodically
at the shoe store to determine whether his or her feet have grown enough
to warrant a larger pair of shoes.

Remember that the primary purpose
of shoes is to prevent injury. Shoes seldom correct children's foot deformities
or change a foot's growth pattern. Casting, bracing or surgery are often
needed if a serious deformity is present. If you notice a problem, have
your child examined by an orthopaedic surgeon.

Because high-top
shoes tie above the ankle, they are recommended for younger children who
may have trouble keeping their shoes on. Contrary to common belief, however,
high-top shoes offer no advantages in terms of foot or ankle support over
their low-cut counterparts.

Most men's shoes conform to
the shape of the feet and have a roomy toe box with sufficient horizontal
and vertical space and alow heel (usually about half an inch high).
Soles made of hard materials such as leather orsoft materials such
as crepe can both be worn, but softer soles tend to be more comfortable.
If you stand for extended periods of time, shoes with soft, pliable soles
will protect your feet and help keep them comfortable.

Work shoes are
also available with varying characteristics, depending on the wearer's occupation.
Boots made of thick leather with steel toe boxes can be worn to protect
the feet from injury. Boots with varying degrees of traction also are available.

Low-heeled shoes
(one inch or lower) with a wide toe box are the ideal choice for women.
An ample toe box that can accommodate the front part of the foot is as important
as the heel in determining fit.

High-heeled, pointed-toe shoes
can cause numerous orthopaedic problems, leading to discomfort or injury
to the toes, ankles, knees, calves and back. Most high heeled-shoes have
a pointed. narrow toe box that crowds the toes and forces them into an unnatural
triangular shape. These shoes distribute the body's weightunevenly,
placing excess stress on the ball of the foot and on the forefoot. This
uneven distribution of weight, coupled with the narrow toe box characteristic
of most high heels, can lead to discomfort, painful bunions, hammertoes.
and other deformities.

The height of
the heel makes a dramatic difference in the pressure that occurs on the
bottom of the foot. As heel height increases, the pressure under the ball
of the foot may double, placing greater pressure on the forefoot as it is
forced into the pointed toe box.

Even low-heeled
shoes can cause problems if they don't fit well. Years of wearing too-small
shoes can lead to permanent deformities.

The purpose of
athletic shoes is to protect the feet from the specific stresses encountered
in a given sport and to give the player more traction. A jogging shoe will
be designed differently from an aerobics shoe, for example. The differences
in design and variations in material, weight, lacing characteristics and
other factors among athletic shoes are meant to protect the areas of the
feet that encounter the most stress.

The key ingredient
in a well-fitted athletic shoe is comfort. A good fit will reduce blisters
and other skin irritations.

Your orthopaedist is a medical
doctor with extensive training in the diagnosis, and nonsurgical and surgical
treatment of the musculoskeletal system, including bones, joints, ligaments,
tendons, muscles and nerves.

This brochure was prepared by
the American Academy of Orthopaedic Surgeons and is intended to contain
current information from recognized authorities. It does not, however, represent
official policy of the Academy, and its text should not be construed as
excluding other acceptable viewpoints.

1993 American Academy of Orthopaedic
Surgeons
This material may not be modified without the express written permission
of the American Academy of Orthopaedic Surgeons.

Lacing Techniques
(This info. is also from American Academy of Orthopaedic Surgeons; this
link will also bring you to their web site).